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Pioglitazone for sudden sensorineural hearing loss

Pioglitazone given both as an injection (directly into the inner ear) and oral tablets is being investigated as a treatment option for sudden sensorineural hearing loss (SSNHL) in adults.
SSNHL, also known as sudden deafness, is an unexplained loss of hearing, typically in one ear and can happen instantly or over a span of several days. During this time, sound gradually
becomes muffled or faint. SSNHL happens when organs in the inner ear or the nerve pathways between the ear and the brain become damaged. Whilst no medicines are
authorised to treat the hearing loss itself, steroids are used to treat the symptoms or antibiotics if the cause is infection. Cochlear implants can be used but this does not
completely restore hearing but amplifies sounds to a more normal level.
Pioglitazone is typically a blood glucose‐lowering drug licensed for the treatment of type 2 diabetes mellitus. While the way it works in SSNHL is not yet fully understood, it is thought
to reduce inflammation and improve oxygen supply to cells in the inner ear that are involved in SSNHL. Pioglitazone is known to regulate the expression of proteins (receptors) involved
in a variety of physiological processes, including lipid and glucose homeostasis, inflammation, and organ protection. If licensed, pioglitazone, via its multiple favourable mechanisms of inner ear protection, may offer a new option for the treatment of SSNHL.

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